Gail Ironson, Aurelie Lucette and Roger C McIntosh
Background: Active patient involvement is one of the aims of patient-centered care. Little is known regarding the unique impact of patients’ active participation in their care on health outcomes, and scales are needed to measure this construct. The aim of the present study was to examine the application of the Doctor-Patient Relationship: Active Patient Involvement (DPR:API) scale, a 5-item scale, in predicting relevant health outcomes among HIV positive patients.
Methods: In Study 1 we compared active patient involvement between long survivors (those who survived more than twice as long as expected after getting an AIDS defining symptom; n=176) and normal course controls (HIV positive patients; n=79). Study 2 was a longitudinal study following the normal course controls to determine whether active patient involvement at baseline would predict adherence to combination antiretroviral therapy (ART; percentage of missed doses) using the AIDS Clinical Trials Group scale (ACTG) at one-year follow-up.
Results: In Study 1, long survivors were significantly higher on active patient involvement than the normal course HIV controls. In Study 2, hierarchical multiple regression models showed that patients’ involvement in their care at baseline significantly predicted change in percentage of missed doses one year later, such that patients who were more involved early in treatment became more adherent to ART after one year.
Conclusion: Findings highlight the relevance of patient involvement in their care to important health outcomes. Interventions designed to help patients become more active in their care throughout the illness trajectory might positively affect medication-taking behaviors and survival. The DRP:API offers an easy and quickly-administered tool to assess patient involvement within the context of both research and practice.
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Journal of AIDS & Clinical Research received 5061 citations as per Google Scholar report
